臺灣博碩士論文加值系統

醫師費一直是個備受關心及爭議的話題，而影響專科醫師收入的因素亦不斷被探討，本研究針對臺灣地區26061位具有不同專科別身份的醫師和360個地區級以上之醫院經營負責者以郵寄問卷方式進行調查，探討從專科醫師的角度和從醫院經營負責者的角度來看，影響醫師實際收入、目標收入的因素及其差異性比較，總共回收有效專科醫師問卷和醫院問卷各為1921份和70份，其研究結果顯示：
（1） 各專科別醫師期待本人月收入在25.97萬元到38.75萬元之間，實際月收入在17.97萬元到28.84萬元之間；
（2） 72.4％受訪醫師認為自己的收入比其他同專科之專科醫師的收入要少；
（3） 79.6％受訪醫師滿意於所選擇之工作；
（4） 71.7％受訪醫師滿意於目前的工作環境；
（5） 男性醫師平均實際月收入（19.68+13.47萬元）和期望月收入（31.19+17.26萬元）比女性醫師的實際月收入（16.79+9.33萬元）和期望月收入（27.54+13.58萬元）高；
（6） 40至49歲年齡群醫師的實際月收入顯著高於其它年齡群；
（7） 不同職位的醫師實際月收入具有顯著差異，住院醫師比主治醫師少104,572元，主任及副院長、院長分別比主治醫師多46,919元和49,044元；
（8） 對所選擇的工作感覺尚可、差不多、滿意或很滿意者，其實際月收入分別比感覺不滿意或不太滿意者分別多出25,515元和45,131元；
（9） 對所目前工作環境感覺尚可、差不多、滿意或很滿意者，其實際月收入分別比感覺不滿意或不太滿意者分別多出33,356元和55,068元；
（10） 在私立醫學中心、私立區域級醫院或地區級醫院、私立診療所工作之醫師，其實際月收入分別比在公立醫學中心工作之醫師多44,721元、39,419元和16,067元。
本研究建議，在考慮台灣地區醫療生態的平衡發展時，應考慮修正現行的健康保險給付制度，以及目前所存在的專科醫師別、醫院層級與年齡等因素之影響，提供醫療政策決定者在制訂政策或專科醫師人力規劃時的參考。

The market value of medical specialists has been a topic of special concern. There are tremendous discussions about the influencing factors of the market value of medical specialists. We have interviewed 26061 medical specialists and 360 hospitals ranked higher than district hospital to explore the influencing factors of market value of medical specialists. There were 1921 and 70 effective samples of medical specialists and hospitals, respectively. The results are:
1) The average expected monthly incomes and actual monthly incomes of medical specialists are 259.7+148.9 to 387.5+212.1 thousand dollars, respectively;
2) 72.4% of medical specialists interviewed felt that their incomes are less than those of other specialists;
3) 79.6% of medical specialists are satisfied with their present work;
4) 71.7% of medical specialists are satisfied with their working environment;
5) the actual monthly incomes and expected monthly incomes of males (196.8+134.7 thousand dollars and 311.9+172.6 thousand dollars) are higher than those of females (167+93.3 thousand dollars and 275.4+135.8 thousand dollars, respectively);
6) the actual monthly incomes of specialists aged 40 to 49 are significantly higher than those of other age groups;
7) the actual incomes of resident doctors are 104,572 dollars less than those of visiting doctors, chiefs and superintendents have 46,919 dollars and 49,044 dollars, respectively, higher than those of visiting doctors;
8) the actual incomes of specialists satisfied with their jobs are 25,515 dollars and 45,131 dollars, respectively, higher than those of specialists of no ideas, and unsatisfied with their jobs;
9) the actual incomes of specialists satisfied with those working environments are 33,356 dollars and 55,068 dollars, respectively, higher than those of specialists with no ideas, and unsatisfied with their working environments;
10) the actual incomes of those working at private medical centers, private regional or district hospitals, and private clinics are 44,721， 39,417 and 16,067 dollars, respectively, higher than those of specialists working at public medical centers.
The suggestions we proposed are that considerations of influences of different specialists, hospital rankings, and ages of specialists should be taken into account when the balanced development of medical ecology system in Taiwan is under consideration.

第一章 前言 -------------------------------------------- 1
第一節 研究背景與動機 --------------------------------- 2
第二節 研究目的 --------------------------------------- 3
第二章 文獻探討 ---------------------------------------- 4
第一節 市場價值--------------------------------------- 4
第二節 醫師的市場價值--------------------------------- 6
第三節 影響醫師市場價值的因素-------------------------10
第三章 研究材料與方法 ----------------------------------16
第一節 研究設計與研究架構 ----------------------------16
第二節 研究變項之操作型定義 --------------------------17
第三節 研究材料與方法 --------------------------------30
第四節 資料處理與分析 --------------------------------34
第四章 研究結果 ----------------------------------------37
第一節 專科醫師收入情形 -------------------------------37
第二節 醫院經營負責者給付情形 -------------------------44
第三節 影響專科醫師收入因素 ---------------------------50
第五章 結論與建議 --------------------------------------57
第一節 研究結果討論 -----------------------------------57
第二節 研究限制 ---------------------------------------65
第三節 未來研究建議及政策啟示 -------------------------66
參考文獻 -----------------------------------------------68
表 -----------------------------------------------------75
附錄 --------------------------------------------------103

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